Dirigible catheter



Oct. 7, 1969 J. BARcHlLoN DIRIGIBLE CATHETER 4 Sheets-Sheet 1 FiledSept. 28, 1966 INVENTOR BmfcMon John 3f Momo/Mq DI w wg ATTORNEYS Oct.7, 1969 J. BARCHILON DIRIGIBLE CATHETER 4 Sheets-Sheet 2 Filed Sept. 28,1966 John Boxdmbh BY .910160 wwbxqww ATTORNEYS Oct. 7, 1969 J. BARcHlLoNDIRIGIBLE CATHETER 4 Sheets-Sheet 5 Filed sept. 2a. 196e INVENTOR Bcxvch\ov1 John BY Dafo ATTORNEYS Oct. 7, 1969 J. BARcHlLoN DIRIGIBLE CATHETER4 Sheets-Sheet 4 Filed Sept. 28, 1966 INVENTOR BY ma@ a www@ ATTORNEYSUnited States Patent O 3,47 0,876 DIRIGIBLE CATHETER John Barchilon, 436E. 69th St., New York, N.Y. 10021 Filed Sept. 28, 1966, Ser. No. 582,624

Int. Cl. A61m 25 00; A61b 5/10 U.S.y Cl. 128--348 `9 Claims ABSTRACT FTHE DISCLOSURE This disclosure relates to a dirigible catheter havingThis invention relates to catheters, and more particularly relates todirigible catheters.

A catheter is basically a tube-like member insertable into a bodypassage or cavity which may be used for drawing off samples, or forother medical purposes. This invention relates to such devices andprovidesI a new and improved catheter which is guidable through 360degrees.

Cathetens which have been capable of some guidance in direction of thedistal end from the proximal end have heretofore been proposed. Suchproposed guidance was usually accomplished by one tensioning member inthe form of a wire or cord which extended along the length of thecatheter within its innerv channel or bore, Wasattached adjacent thedistal end of the catheter, and tensioning the cord from the proximalend of the catheter would bend the tip or distal end of the catheter inone direction.

Additionally, some 'catheters have been proposed which require such atensioning cord as a guide means .but offset the bore of the catheter.Such construction resulted in extremely thick walls of the catheter and,therefore, reduced the bore thereof and its usefulness.

A catheter must be highly flexible so that it can be turned upon itself,yet sufficiently rigid to be Ipushed from its proximal end withoutkinking upon itself. Its external diameter is limited both by thepassage in whichl it must be inserted and by the requirements forstrength and longitudinal rigidity required for insertion andmanipulation.

The present invention provides a new and improved thin-walled catheterwhich has a high ratio of bore or lumen dimension to overall diameter.Tlhe structure of this catheter is such that :both the outer walls andthe inner walls la-re smooth and cylindrical, and the bore is concentricwith the outer cylindrical walls. However, the walls have such strengthas to Ireceive a plurality of tension means therein Ito allow the distalend thereof to be guided from the proximal end through 360 degreesfreedom of motion.

Moreover, the construction is such that the guide lines may besimultaneously manipulated to easily guide the distal end of thecatheter. The structure is further such that the walls may be made thinto maximize the ratio of the external diameter to the internal diameter.The invention Ifurther provides a catheter having a continuous bore ofconstant diameter concentric with the lou-ter walls and having noobstructions therein which would hinder maximum utilization of thecatheter.

Accordingly, an object of this invention is to provide a new andimproved catheter.

Anotlher object tof this invention is to provide a new and improvedcatheter having an increased ratio of internal diameter to `externaldiameter.

A further object of this invention is to provide a new and improvedcatheter having a distal end which is Idirigible through 360 degrees ofmotion.

Another object lof this invention is to provide new and improved meanslfor guiding the distal end of a catheter from the proximal end thereof.

Further objects and `advantages of the invention will in part Ibepointed out and in part be made apparent from the following description.

The features of the invention which are believed to be novel are setforth with particularity and Idistinctly claimed in the concludingportion of this specification. However, the invention both as to itsorganization and operation, together with further objects and advantagesthereof may best be appreciated by reference to the following detaileddescription taken in conjunction with the drawings, in which:

FIG. l is a view in longitudinal section of a catheter embodying theinvention;

FIG. 2 is 'a `sectional View seen in lthe plane of lines 2-2 of FIG. 1;

FIG. 3 is a view of a catheter embodying the invention together with theguidance mechanism therefor;

FIG. 4 is an enlarged view of the operating mechanism of the catheter ofFIG. 3 shown partly in section;

FIG. 5 is a view seen in the plane of lines 5-5 of FIG. 4;

FIG. 6 is a view seen in the plane of lines 6 6 of FIG. 4;

FIG. 7 is an enlarged view of a portion of the operating mechanism shownin FIG. 4;

FIG. 8 is a lsectional view seen inthe plane of lines 8 8 of FIG. 7;

FIG. 9 is a view in half section of another operating mechanism Ifort-he catheter of FIG. 1;

FIG. 10 is a sectional view seen in the plane of lines 10--10 of FIG. 9;

FIG. 11 is a view in section of a portion of the operating mechanism ofFIG. 9; and

FIG. 12 is a schematic diagram showing the circuit connections for theoperation of the mechanism of FIG. 9.

A catheter embodying the invention is generally indicated by thereference numeral 10 and comprises an outer cylindrical wall member 11which is continuous along the length of the catheter 10. At the distalend 12 of catheter 10 is a tip or end piece 13 of fairly rigid materialhaving an inwardly directed flange-like portion 14 which ts over the endof the inner catheter tube 15, and which further has a cylindricalportion 16 surrounding the inner catheter tube 15 at the distal endthereof and wlhich is bonded thereto. The member 13 further 'has aflange 17 thereon which receives guiding or tensioning cords 18a, 18b,18C and 18d. These cords or lines are fastened to ange 17 to preventbeing pulled therefrom, as by enlargement of the ends thereof byknotting of end pieces attached thereto. The cords extend throughtube-like members, 19a, 1911, 19e and 19d, disposed at 90 degrees withrespect to eacih other within the catheter body. A nose piece 20 isdisposed about member 13 and extends back to a body member 21. Member 20may be recessed as at 22 to enhance freedom of movement of the cords 18.Body member 21 may be formed with a shoulder 23 adapted to receivethereon the end of nose piece 20, and provide a continuous outerdiameter therewith.

The catheter 10 is assembled by disposing tubes 19a and 191) about innercatheter tube 15 at 90 degrees around Uhe circumference of tube 15. Thisassembly is then molded within member 21 which is of a suitable exiblematerial. One such material which has been found to have beensatisfactory is a silicone compound RTV 11 of the General ElectricCompany. The inner tube 15 and tubes 19a- 19d'are chosen to be exible,and suitable materials have been found to be polyethylene or vinyl.During this molding operation a reinforcing sleeve of a suitable meshmaterial 24 is preferably disposed about the catheter tube 15 and theguide tubes 19a-19d and molded within member 21 to provide reinforcingif deemed necessary.

The member 13 is then fitted over the distal end of tube 15 and theguide or tension cords 18 may be attached and threaded through tubes 19.Member 20, which has previously been molded of similar compound asmember 21, is then iitted over member 13 and extended into the shoulder23 on member 21. Then the outer tubing 11 which has been separatelymolded is slipped over members and 21 to provide a smooth outer surfacewhich is continuous throughout its length.

This construction provides a catheter which is continuous and ofconstant cross-section throughout its length except for the roundeddistal end 12. Further, the inner tube 15 is of constant cross-sectionthroughout its length with no obstructions therein and defines the innercatheter passage or lumen 26.

The catheter tube described may be varied in length from less than onefoot to more than thirty feet, depending upon its usages which may be toinject radiopaque dyes quickly to points where lesions are suspected.Barium can be squirted directly in the region of the duodenal bulb, orthe ascending colon. The catheter is further ideal for transporting ahighly flexible, but rather unwildy, fiberscope. For example, a cathetercould be passed into the tracheobronchial tree and with the berscope, asuspected epithelial lesion could be located. Furthermore, when thecatheter is in the proper position, suction could be applied and cellscan be aspirated for a cytological examination.

The cross-sectional diameter may vary from between one-eighth inch up totwo inches, again depending upon its desired use. The inner diameterwill vary correspondingly, but will generally be about sixty percent ormore of the outer diameter.

The materials of the catheter tube are made of flexible compounds suchthat it can be bent and turned on itself to make right angle turns andconform to pretzel congurations. Its tiexibility range is such that itis suliiciently rigid to be pushed from its proximal portions -withoutkinking on itself, and at the same time exible enough to make theabove-mentioned bends. The specific flexibility of the material willvary depending on its intended use. The previously mentioned GeneralElectric Company RTV 1l silicone compound has a durometer of 48. Thecatheter tube itself is not subjected to tension greater than thatrequired to pull or push it. The guide lines 18 running within its wallsmay be subjected to approximately twenty pounds of pull, depending uponthe use of the catheter. These guide lines 18 may be made of wire,nylon, surgical silk or other suitable materials. It has been determinedthat the above-mentioned material can be autoclaved at 250 degreesFahrenheit for forty-five minutes, which is more than sutlicient toassure its sterility.

Returning to FIGS. l and 2, it may be seen that tensioning one or moreof the guide cords 18 will produce bending of the distal end of thecatheter 10 as represented by the broken line 27. For example, thebending of the distal end shown in FIG. 1 may result from merelyapplying tension to the 180 degree line 18e which would exert a pulldownwardly as shown in FIG. l on the ange 17 of member 13. Byselectively tensioning different ones of lines 18a-18d the distal endmay be directed in any direction throughout 360 degrees with respect toa plane perpendicular to the axes thereof.

Reference is now made to FIG. 3 which shows the Catheter 10 mounted to amanipulating device 30 which contains a mechanism for selectivelyoperating `the cords 18a-18d. The manipulating device is exemplified inthe form of a member having a pistol grip 31 which has a passage 32defined therethrough which is coaxial and of essentially the same sizeas lumen 26.

The catheter `tube 11 is coupled to the `assembly 31 by means of anadaptor 34. Adaptor 34 at one end thereof has longitudinally extendinglfingers 35 defined by longitudinally extending slits 36 therein, and isthreaded at 37 to receive a chuck-like member 38. Adaptor member 34further includes a collar-like member 39 received in an undercut 40therein which has internal threads 41 adapted to mate with threads 42 onthe exterior of barrel 43. To assemble the catheter tube to the handleand operating assembly, the lines 18a-18d are connected to mating lines18a-18d' extending from an operating mechanism, hereinafter described,as by means such as hook and eye connectors 44. Then adaptor 34 isfitted to barrel 43 and has an intercocking tit as indicated at 45therewith. Then the collar-like member 39 is threaded on t-o handlemember 30 and the adaptor is made fast to handle `30.

Then the catheter tube is pulled outwardly of adaptor 34 to tension thelines 18a-18d so that there is no slack therein, and all lines areequally tensioned with the distal end of the catheter tube unbent. Atthis time, chuck-like member 38 is threaded tightly on to adaptor 34 sothat the inclined portion 38a of chuck-like member 38 rides up overlingers 35 and compresses lingers 35 about the catheter tube. Thiscompression of the fingers 35 about catheter tube 11 `holds it securelyin place and prevents either longitudinal or rotational movement thereofwith respect to barrel 43.

The lumen of catheter 10 is now coaxially aligned with the passage 32dened in 'barrel 43.

Disposed within barrel 43 is a bushing or sleeve-like member 46 whichacts as a guide for lines l8a'-18d extending from a guiding cont-rolmechanism 47. The function of sleeve 46 is to space the guide lines18a-18d' as they change from a generally inclined direction with respectto the lumen of the catheter to a direction which is parallel of theaxis -of the lumen of the catheter. This further provides a clear accessto the lumen through the barrel 43. This is more clearly shown in FIG.6. It will be noted that the line 18a must cross passage 32 withoutadding an obstruction thereto. This is done by gently curving line 18ain a helical path about the bushing or sleeve 46, and for this purposesuch Ia path may be dened therein. In this manner, appropriatelycontoured passages may be defined in the exterior periphery thereof yforany yor all of line 18a18d as may `be required.

The catherter guidance mechanism 47 is more clearly shown in FIGS. 6-8.This mechanism provides a means for guiding the distal end of thecatheter through 360 degrees projected on one plane.

The lines or cords 18a and 18C', and 18b' and 18d are in continuouspairs, each pair disposed about a wheel which upon rotation thereoftensions one line of a pair and releases tension in the other line ofthe pair.

The guidance mechanism 47 comprises a base member in the form of a plate49 having `an aperture defined therethrough which receives a ball 50.Ball `50 is vrotatable in plate 49 and retained in position with respectthereto by upper and lower -retaining plates 51 and 52. Extendingthrough ball 50 is 1a shaft 53 having a trimble-like end piece 54adapted to receive a iinger for manipulation of shaft 53.

Shaft 53 extends through an opening 55 delined by two pairs of half ringmembers 56, 57; and `58, 59, disposed perpendicular to each other.Members 56 and 57 are secured at their ends to coaxi-al shafts `and 61which are rotatably carried in brackets 62 and 63, respectively, whichare in turn carried on plate 49. Similarly, members 58 and 59 aresecured to shafts 64 and 65, rotatably carried in briackets 66 and 67,mounted on plate 49.

Mounted to shafts 61 and 65 are gears 68 and 69, respectively. Alsorotatably carried in brackets 62 and 67 are shafts and 71, respectively.Mounted to shaft 70 is a gear 72 in meshing engagement with gear 68.When vgear 72 is driven by gear 68 it'rotates a sheave 'or wheel 73.Mounted to shaft 71 is a gear 74 and wheel 7S. When gear 69 rotates gear74 it also rotates a sheave or wheel 75.

Disposed about wheel 73 are lines 18b' and 18d. Disposed about Wheel 75are lines 18a and 18e.

In operation, it may be seen that when 'shaft 53 is manipulated it willact against one or both pairs of members 56, 57 or 58, 59 and producerotation of'one or both of shafts -61 and/or 65. This will produceresultant rotation of one or both of wheels 73 and 75.l Wheel 73, aboutwhich is wound lines 18b and 18d, upon rotation thereof, will tensionone of the lines and provide slack in the other of the lines. Similarly,rotation of wheel 75 will tension oneA of lines 18a or 18e and provideslack in the other of the lines. "llherefore, any two of lines 18athrough 18d residing at righ-t angles to each other may besimultaneously tensioned to exert a pulling force on member 1,3 and,therefore, bend and guide the distal end of the catheter through 360degrees.

It may thus be seen that this operating mechanism, While providing 360degrees of motion at the `distal end of the catheter tube, allows thegui-de lines which are 180 degrees apart to be tensioned and slackedsimultaneously, and fur-ther provides that varying amounts of tensionmay be applied to the guide lines which are 90 degrees apart .to bendand position the distal end of the catheter Iat any angle.

While the degree of motion has been spoken of as 360 degrees, it will beunderstood that this refers to 360 degress in one plane which isperpendicular to the axis of the catheter in its relaxed position, andfurther provides for three-dimensional positioning of the distal end ofthe catheter with respect to such 360 degrees.

Other techniques of selectively tensioning one of a pair of the guidelines may be utilized. FIG. 9 shows an alternate embodiment 4which workson 4an electromagnetic principle. In FIG. 9 each of the lines '18a-18dare connected to the plungers 80er-80d of electromagnets having coils81a-81dgDependent upon the magnitude of energization of the coils, theplungers therein will either advance as shown in FIG. 9 or be retractedtowards the left. Each of the electromagnets is disposed 90 degrees withrespect t-o the axis of the catheter within a housing member 82 havingAa bore 83 coaxial with the catheter lumen.

The electromagnets are selectively energized through a mechanism similarto that shown in FIGS, 6-8. This mechanism lis illustnated in fFIG. 11and like reference numerals to those used in FIGS. 6-8 identify likeelements in FIG. 11. In the mechanism 84, the shaft 61 has mountedthereto the contact arm 85 of a potentiometer 86. The shaft 65 carries acontact arm 87 of a potentiometer 88.

The circuit connection to the potentiometers 86 and 88 with coils81a-81d are shown in FIG. 12. It will be noted that the current fromva-source such as battery 89 is applied to both of the contact arms 85and 87, and when these contact arms are on the midpoint of theresistance of potentiometers -86 and 88 all coils will be equallyenergized and the tension in all 0f lines 18a-18d will -be equal.However, when the contact arms are displaced as 'shown in FIG. l2, coils81a and 81b will receive more current than coils y81C and 81d,respectively. Therefore, lines 18a and 18d will be tensioned withrespect to other lines and the distal end of the catheter will be guidedin a quadrant dened by the lines 18a and 18b.

It may thus be seen that by proper manipulation of shaft S3 with onetinger, the distal end of the catheter may be guided through 360degrees, and provides continuous three-dimensional vectonal resolutionto coordinate axes. Preferably, a pistol-type grip las illustrated isused to handle the manipulation assembly so that the distal end of thecatheter may be guided through use of one dinger.

The disclosed catheter may have many applications. 'For example, inradiology, the catheter provides a means by way of which radiopaque dyescan be injected quickly to points where lesions are suspected. Thedisclosed catheter is ideal for transporting the highly flexible, butrather unwieldy fiberscope. In another embodiment of the invention aIfiber-scope could be incorporated into the walls of the catheter andthe catheter lumen would be then used for providing instrumentation. Forexample, the catheter with la built-in iiberscope could be passed intothe tracheobronchial tree and a suspected epithelial lesion located.Then suction could be applied to the region in question and cells coul-dbe aspirated for cytological examination. Further, this catheter wouldbe useful in pulmonary embolectorny. Once the ldisclosed catheter, forexample, with a fiberscope therein is utilized to locate an embolus(cardiac catheterization and injection of radiopaque dye underiiuoroscopy) a second catheter, the embolectomy catheter, which consistsof a small plastic drill piece Iwould be utilized to break up and drivethe thrombus linto the catheter. Suction applied :at pressures greaterthan right ventricular systole would cause bits of thrombus to be suckedback through the embolectomy catheter. Additionally, the embolectomycatheter could be utilized for taking small samples which would be drawnback into the disclosed catheter.

From the foregoing disclosure, it may be seen that the objects of theinvention set lorth as well as those made apparent `from the preceding`description are ediciently attained. While presently preferredembodiments of the invention have been set -forth for purposes ofdisclosure, other embodiments of the invention and modilications to thedisclosed embodiments which do not deplamt from the spirit and scope ofthis invention may oc cur to others skilled in the art. Accordingly, theappended claims are intended to cover all embodiments of the inventionas well als modifications to the disclosed embodiments of the inventionwhich do not depart from the spirit 'and scope thereof.

What is claimed Lis:

1. A catheter comprising a flexible elongated tube hav ing a proximalend and a distal en-d adapted to be inserted into a body passage, saidtube having a continuously smooth outer `surface `and continuouslysmooth inner walls defining a continuous unobstructed passage from saidproximal end to said distal end, a plurality of guide lines anchoredadjacent the distal end of said tube and equiangularly between the wallsdefining the passage and the outer surface of the catheter, said linesbeing longitudinally movable with respect to said tube, said lines beingfour in number and disposed degrees about said catheter, the linesdegrees apart forming a pair, to means for tensioning said linesincluding means for simultaneously tensioning one line of a pair andreleasing tension in the other line of a pair.

2. The catheter of claim 1 wherein said catheter -further comprises aninner tube derning the continuous passage 'and an |outer |tube definingsaid outer surface spaced from said inner tube, said lines beingdisposed .about said inner tube, means secured to said inner tubeadjacent the distal end thereof, land said lines being anchored to saidcoupling means.

3. The catheter of claim \1 wherein said means for tensioning compriseselectrornagnetically operated means connected to each of said lines,energizing means for said electromagnetically operated means, saidenergizing means being differentially connected so that as the tensionin one of said lines of a pair is increased the ten-sion in the other ofthe line of a pair is decreased.

4. An elongated tube-like member comprising -an inner exible tube memberhaving a smooth, continuous inner wall, an outer flexible tube memberdisposed about said inner tube and having a s-mooth continuous outersurface, means coupling said tubes at the distal ends thereof, our`guide lines disposed at 90 degrees with respect to each 7 other betweensaid tubes and securedlto Said coupling means, and means `forselectively tensioning two lines and releasing 'tension the lines 180`degrees therefrom.

5. The apparatus of claim 4 wherein said coupling means comprises amember disposed about and secured to said inner tube and having anannular flange adapted to receive said lines.

6. A catheter comprising an elongated flexible tube member havingproximal and distal ends, two pairs of force-producing lines extendingalongsaid member between said proximal and distal ends, the lines ofsaid pairs being spaced substantially 180 degrees apart so that Saidexible member may be caused to bend by exerting a force on one line of apair and releasing force on the other line of a pair,electromagnetically operated force-producing means for each of saidlines, means connecting each of said lines to one of Saidelectromagnelically operated means, and energizing means forsimultaneously operating two of said electromagnetically operated meansto release forced on one line of a pair and apply force to another lineof a pair.

7. The apparatus of claim 6 further including means for simultaneouslyenergizing all of said electromagnetically operated means in pairs.

8. The apparatus of clairn 6 wherein Said electromagnetically operatedmeans comprise two pairs of electromagnets having magnetic elementsmovable in a direction and magnitude dependent on the strength of amagnetic eld applied thereto, means for producing magnetic elds for eachof said magnetic elements and means for simultaneously Strengthening thefield of one electromagnet of a pair and weakening the field of theother electromagnet of a pair.

9.*The apparatus' of claim 6 wherein said energizing means for each pairof lines includes a potentiometer having a resistance and contact arm,each pair of energizing means` being .connected to opposite ends of onepotentiometer resistance and differentially energized therethroughdependent of the position` of the Contact arm on said re- Sistance, andmeans connected to Said contact arms to allow simultaneous andindependent movement of the contact arm of each potentiometer.

References Cited UNITED STATES PATENTS 2,432,869 12/1947 Elmer 244-87X2,453,862 11-/1948 Salisbury 128-9 2,498,692 2/1950 Mains 128-3482,836,253 5/1958 Lovell 18o-27 2,975,785 3/1961 Sheldon 128-6 3,058,47310/1962 Whitehead 128-349 3,091,235 5/1963 Richards 128-6 3,183,4105/1965 Fiora 335-268 x 3,190,286 6/1965 Stokes 128-6 3,162,214 12/1964Bazinet 128-4 `FOREIGN PATENTS 548,462 10/1942 Great Britain.

DALT ON L. TRULUCK, Primary Examiner U.S. Cl. X.R.

'(gjtlgo UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION PatentNo. 3, l470 876 Dated October 7 1969 Invencor(s) John Barchi lon It iscertified that error appears in the above-identified patent and thatsaid Letters Patent are hereby corrected as shown below:

r- Column 6, line 52, after "pair," delete the word "to" and substitutetherefor and Column 7, line 20, delete "forced" and substitute thereforforce SIGNED ND SEALED JUN 9 1970 'ximvvjl'Ufnn'a f. r. .jgmgj' ,mxm(SEAL) Auen:

WIIILIAM E? ISGHUYIIER, J'R. r. Edvard Mjitcher'] Commissioner ofPatents Atteating cer

